| NPI | 1609069103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA DO.000009) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA DO.000009) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2023-01-15 |